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Number Name Tax Year Revision Date
2175 Missouri Cigarette or Other Tobacco Products Tax License Application 4/4/2014
265-20 Consolidated Monthly Cigarette Tax Report (20s only) 9/26/2014
265-25 Consolidated Monthly Cigarette Tax Report (25s only) 9/26/2014
266 Schedule A - Cigarette Receipts From Manufacturers or Importers 10/3/2014
267 Common Carrier Monthly Report Cigarette Tax 5/22/2014
2827 Power of Attorney 4/18/2018
2879 Irrevocable Letter of Credit 2/27/2015
304 Cigarette Tax Stamp Record - Schedule C 6/27/2013
331 Surety Bond 2/28/2015
332 Cash Bond 2/27/2015
4172 Assignment of Certificate of Deposit 2/27/2015
4341 Other Tobacco Products Summary First Sale Retailers Monthly Report of Purchases 7/7/2014
4342 Other Tobacco Products Monthly Report - Out of State Wholesalers Selling into Missouri 6/27/2014
4343 Other Tobacco Products Receipts Schedule 4/2/2014
4357 Other Tobacco Products Tax Exemption Certificate 5/30/2014
4387 Tobacco Products Tax - Other Than Cigarettes 6/27/2014
4388 Tobacco Products Other Than Cigarettes New Inventory - Schedule A 8/5/2014
4389 Tobacco Products Other Than Cigarettes Customer Returns to Inventory - Schedule B 4/24/2014
4390 Tobacco Products Other Than Cigarettes Export Sales - Schedule C 5/22/2012
4405 Cigarette Decal Purchase Order Form 7/31/2017
4426-20 Out of State Missouri Cigarette Wholesaler Monthly Cigarette Tax Report (20s only) 6/21/2016
4426-25 Out of State Missouri Cigarette Wholesaler Monthly Cigarette Tax Report (25s only) 6/21/2016
4592 Request for Cigarette Tax Records 6/25/2014
4732 Cigarette and Other Tobacco Products Registration Change Request 7/17/2014
4790 United States Importers Cigarette Sales to Missouri Wholesalers Monthly Tax Report 5/14/2014
4791 Tobacco Products - Other Than Cigarettes Retailer Tax-Paid Purchases from Missouri Licensed Wholesalers - Schedule F 1/15/2015
4795 Tobacco Products Other than Cigarettes Export Sales - Schedule A 4/16/2014
4916 Licensee's Monthly Report of Cigarettes 8/21/2019
5067 Consumer Payment Voucher - Cigarette/Other OTP 5/30/2014
5298 Registration for Electronic Notification of Changes in the Missouri Tobacco Directory 2/9/2015
5299 Registered Agent Statement - Name and Address of Missouri State Registered Agent 2/9/2015
5300 Non-Participating Manufacturer's (NPM) Appointment of Registered Agent for the State of Missouri 2/9/2015
5301 Missouri Tobacco Directory - Participating Manufacturer Brands Certification 9/29/2014
5302 Escrow Compliance Certificate and Affidavit (Non-Participating Manufacturers) 3/14/2019
5303 Missouri Tobacco Directory - Non-Participating Manufacturer Brands Certification 2/9/2015
5304 Missouri Tobacco Directory - Non-Participating Manufacturer Certification 2/9/2015
5305 Missouri Tobacco Directory - Participating Manufacturer Certification 2/9/2015
5378 Agreement to Receive Refund by ACH Transfer 4/21/2017
5422 Missouri Tobacco Directory-Supplemental Cigarette and Roll Your Own (RYO) Packaging Change Notification 2/9/2015
5467 State Cigarette PACT Act PA-1 Report for Missouri 2/9/2015
5468 State Tobacco PACT Act PA-2 Report for Missouri 2/9/2015
5622 Cigarette Stamp Refund Request 10/7/2015
783 Export of Stamped Cigarettes Report - Schedule E 4/15/2014
Schedule F Missouri Stamped Cigarettes Sold to Missouri Retailers or Consumers 8/20/2013